On 17 July 2018, Health Protection Scotland (HPS) published the latest malaria surveillance report, showing data up to the end of 2017.

Against a general global downward trend in malaria incidence, this publication reports on malaria episodes diagnosed in Scotland over the period 2013-2017. In 2017, there were 50 reports of malaria in Scotland, a decrease of 14% from 2016. Overall for 2013-2017, there were 292 episodes of malaria reported. The majority of episodes were caused by Plasmodium falciparum (78%) while 14% were caused by P. Vivax. Episodes caused by P. ovale (4%) and P. malariae (3%) were also reported. The majority of episodes were transmitted in West Africa (54%), with Nigeria and Ghana contributing the greatest number of these. East Africa was the next greatest source of reports (15%) followed by Asia (10%), in which Pakistan was the source of the greatest number of episodes (74%). Where a reason for travel was given, people visiting friends and relatives (VFR) contributed 37% of the episodes, followed by business or professional travellers (24%) and holiday travellers (13%). The discussion summarises some recent observations in malaria epidemiology globally, including countries where there have been significant increases in cases in recent years, as well as recent sporadic local outbreaks in Europe. 

Finally, the report summarises advice for travellers highlighting the latest evidence-based guidance on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

On 17 July 2018, Health Protection Scotland (HPS) have published a surveillance report concerning the general outbreaks of infectious intestinal disease.

A revised ‘Rabies Control Strategy for Great Britain’ has been published. Protecting the environment, society and the economy from the risks of animal disease is a priority for government and this document sets out the framework for how an outbreak of rabies in Great Britain would be managed. It covers general control principles for the most likely scenarios for cases of classical rabies virus and the rationale for such controls.

This strategy is intended to support all parties affected during an outbreak of rabies so they are better placed to respond quickly and effectively to control the outbreak and protect public health, regain disease-free status as quickly as possible and minimise the wider impact on the public and the natural environment.

Public Health England (PHE) is advising the public to ensure they have had two doses of the MMR vaccine after outbreaks of measles were confirmed across England.

Between 1 January 2018 and 6 July 2018 there have been 757 laboratory confirmed measles cases in England. Cases were reported in most areas with London (268), the South East (161), the South West (118), West Midlands (85) and Yorkshire and Humberside (73) reporting the most cases (based on provisional figures).

Source: PHE, 12 July 2018

The Portuguese minister of health announced on 5 July 2018 that Portugal has achieved two of the three HIV targets set by the Joint United Nations Programme on HIV/AIDS (UNAIDS), known as the 90–90–90 targets. This puts the country on track to reach all three targets ahead of the 2020 deadline.

The minister’s announcement is based on data from 2016 that finds:

• 91.7% of people living with HIV are diagnosed
• 86.8% of people diagnosed are on treatment
• 90.3% of people on treatment achieve HIV viral load suppression

In the late 1980s and early 1990s, Portugal was among the European countries with the largest number of new HIV infections, relative to its population size. Since the emergence of the epidemic, Portugal has shown its commitment to mounting a strong HIV response based on evidence, adopting people-centred approaches and promoting the involvement of civil society, including people living with HIV.

Source: WHO Europe, 11 July 2018

A new risk assessment has been published by the European Centre for Disease Prevention and Control (ECDC) which evaluates the risk of transmission and further spread of OXA-48-producing Klebsiella pneumoniae ST392 from travellers, having sought medical care in Gran Canaria, to healthcare facilities in their country of origin in the EU/EEA. Between January and April 2018, Sweden and Norway reported a cluster of returning travellers who carried or were infected with carbapenemase (OXA-48)-producing Klebsiella pneumoniae ST392. All cases were associated with hospital admissions in Gran Canaria.

The risk for individual travellers to acquire OXA-48-producing K. pneumoniae ST392 of the Gran Canaria cluster without healthcare contact is very low. However, if carriers of the Gran Canaria cluster are admitted to a hospital in their country of origin there is a high risk of transmission and subsequent outbreaks if OXA-48-producing K. pneumoniae ST392 carriage remains undetected and there are no adequate infection control and prevention measures.

Source: ECDC, 11 July 2018

The World Health Organization (WHO) Regional Office for Europe has published a report entitled ‘Making THE (transport, health and environment) link’. This presents the results of an analysis of how countries can advance the 2030 Agenda for Sustainable Development by working through the Transport, Health and Environment Pan-European Programme.

Since 2002, THE PEP has offered an inter-sectoral policy platform for member states and other stakeholders in the pan-European region to work together to integrate environment and health considerations into transport policies and improve the integration of transport and urban planning. This report presents an analysis of how member states, working through THE PEP, can advance the 2030 Agenda on multiple fronts and offers examples of how THE PEP can help.

Source: WHO Europe, 11 July 2018

The European Environment Agency (EEA) has published a briefing presenting the progress made by the EU and its member states in meeting the emission ceilings that have been applicable since 2010, as set out in the National Emission Ceilings (NEC) Directive.

Since 2010, EU legislation has restricted the emissions of four key air pollutants: nitrogen oxides (NOx), non-methane volatile organic compounds (NMVOCs), sulphur dioxide (SO2) and ammonia (NH3). The EEA briefing finds that six EU member states exceeded the ceilings for one or more pollutants in 2016:

• Austria and Ireland exceeded their ceilings for NOx and NH3
• Croatia, Germany and Spain exceeded their ceiling for NH3
• Hungary exceeded its ceiling for NMVOCs

A further EEA report on updated data from the annual EU emission inventory report 1990-2016, shows that for the third consecutive year ammonia emissions have increased — by 0.4% between 2015 and 2016. The overwhelming majority of NH3 emissions come from Europe’s agriculture sector. Emissions increased in 15 EU member states with Italy, the United Kingdom and Ireland reporting the highest increases.

In general, the road transport sector is the largest contributor to total nitrogen dioxide emissions in the EU, while fuel combustion in the commercial, institutional and households sector is the largest contributor to total primary particulate matter emissions, particularly in some eastern European countries.

Source: EEA, 9 July 2018

The UK Government has awarded a grant to launch a plastics reduction project on the overseas territory of St. Helena. This new projects aims to reduce the amount of plastic used by those living on the island and will establish a recycling programme for waste plastic. As part of this scheme, a marine debris monitoring programme will be established along St Helena’s coastline to better understand this issue. 

The UK Government also re-opened the Darwin Plus scheme (also known as the Overseas Territories Environment and Climate Fund) for the latest round of applications to fund conservation and environmental projects in UK overseas territories on 10 July 2018. This scheme supports the delivery of commitments set out in the 25 Year Environment Plan in UK overseas territories.

Source: UK Government, 11 July 2018